Development and field testing of a consumer shared decision-making training program for adults with low literacy

Danielle M Muscat; Suzanne Morony; Heather L Shepherd; Sian K Smith; Haryana M Dhillon; Lyndal Trevena; Andrew Hayen; Karen Luxford; Don Nutbeam; Kirsten McCaffery

doi:10.1016/j.pec.2015.07.023

Development and field testing of a consumer shared decision-making training program for adults with low literacy

Patient Educ Couns. 2015 Oct;98(10):1180-8. doi: 10.1016/j.pec.2015.07.023. Epub 2015 Jul 28.

Authors

Affiliations

¹ The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia.
² Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia; Psycho-Oncology Co-Operative Research Group (PoCoG), School of Psychology, The University of Sydney, NSW, Australia.
³ Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, NSW, Australia.
⁴ Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Concord Clinical School, The University of Sydney, NSW, Australia; School of Psychology, The University of Sydney, NSW, Australia.
⁵ School of Public Health and Community Medicine, University of New South Wales, NSW, Australia.
⁶ Patient-Based Care, Clinical Excellence Commission, NSW, Australia.
⁷ University of Southampton, Southampton, UK.
⁸ The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia. Electronic address: kirsten.mccaffery@sydney.edu.au.

PMID: 26277281
DOI: 10.1016/j.pec.2015.07.023

Abstract

Objective: Given the scarcity of shared decision-making (SDM) interventions for adults with low literacy, we created a SDM training program tailored to this population to be delivered in adult education settings.

Methods: Formative evaluation during program development included a review of the problem and previous efforts to address it, qualitative interviews with the target population, program planning and field testing.

Results: A comprehensive SDM training program was developed incorporating core SDM elements. The program aimed to improve students' understanding of SDM and to provide them with the necessary skills (understanding probabilistic risks and benefits, personal values and preferences) and self-efficacy to use an existing set of questions (the AskShareKnow questions) as a means to engage in SDM during healthcare interactions.

Conclusions: There is an ethical imperative to develop SDM interventions for adults with lower literacy. Generic training programs delivered direct-to-consumers in adult education settings offer promise in a national and international environment where too few initiatives exist.

Practice implications: Formative evaluation of the program offers practical insights into developing consumer-focused SDM training. The content of the program can be used as a guide for future efforts to engage consumers in SDM.

Keywords: AskShareKnow; Consumers; Development; Health literacy; Intervention; Low literacy; Patient-centred healthcare; Question asking; Shared decision making; Training.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Communication*
Decision Making*
Decision Support Techniques
Female
Health Literacy / methods*
Humans
Interviews as Topic
Literacy
Male
Middle Aged
Patient Education as Topic / methods
Patient Education as Topic / organization & administration*
Patient Participation*
Patient-Centered Care
Physician-Patient Relations
Program Development*
Qualitative Research